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Individualized Reconstitution of Human Milk Microbiota: A Feasible Approach in Real-World Settings
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Donor Milk Banking - Safety, Efficacy, New Methodologies.

Christoph Fusch1,2, Corinna Gebauer3,4

  • 1Department of Pediatrics, Nürnberg General Hospital, South Campus, Paracelsus Medical School Nürnberg, Nürnberg, Germany.

Nestle Nutrition Institute Workshop Series
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Summary
This summary is machine-generated.

Donor milk (DM) provides nutrition for preterm infants but has challenges. Research is needed on pasteurization, safety screening, and nutrient variability to optimize infant growth and outcomes.

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Area of Science:

  • Neonatal nutrition
  • Human milk banking
  • Infant health

Background:

  • Donor milk (DM) is increasingly used for preterm infants, requiring robust banking infrastructure and protocols.
  • DM presents nutritional limitations, including low protein and variable macronutrient content, potentially compromising infant growth.
  • The COVID-19 pandemic has impacted DM banking operations, necessitating adaptations in procedures.

Purpose of the Study:

  • To review current practices and challenges in donor milk banking.
  • To evaluate pasteurization methods, donor screening effectiveness, and nutrient variability in DM.
  • To provide recommendations for optimizing DM utilization in preterm infants.

Main Methods:

  • Review of pasteurization techniques (Holder, high-pressure, UV-C irradiation).
  • Analysis of safety audits and donor screening procedures, including detection of smoking and adulteration.
  • Examination of DM nutrient variability and strategies for fortification and supplementation.

Main Results:

  • Holder pasteurization remains standard, but alternative methods like high-pressure processing and UV-C irradiation show promise for preserving milk properties.
  • Standard donor screening has limitations, with significant rates of undisclosed donor smoking and DM adulteration.
  • DM nutrient composition is unpredictable, impacting infant growth and long-term outcomes.

Conclusions:

  • Advancements in pasteurization and improved donor screening are crucial for safe and effective DM banking.
  • Neonatal caregivers must be aware of DM variability and implement strategies like nutrient disclosure, donor pooling, and targeted fortification.
  • Further research is essential to refine DM processing, fortification, and supplementation protocols to enhance growth and neurodevelopment in preterm infants.